About one in three Covid patients in NHS beds in England are ‘incidental’ cases, meaning they happened to test positive for the virus after being admitted to hospital with a different ailment, official data reveals.
NHS England data shows that of the 8,321 Covid patients in hospital care in England on December 28, the latest available data, only 5,578 (67 per cent) were being treated primarily for Covid, meaning the remaining third were incidental.
This is down from 71 per cent from a week prior, and 74 per cent down from the start of December, meaning the proportion of Covid admissions which are incidental is rising.
So-called incidental Covid admissions are those where someone who comes into hospital for another reason, for example to treat a broken bone and tests positive for the virus shortly after arrival.
This does not necessarily mean they caught the virus while in hospital, as they could have been asymptomatic and only tested positive after being screened for Covid as part of their admission, or could have been isolating after testing positive but needed treatment for an unrelated medical emergency such as a heart attack.
While the proportion of total Covid patients in hospital that are incidental is on the rise, the sheer number of patients being treated for the virus is also increasing.
The 5,578 patients being treated primarily for Covid in England’s hospitals on December 28 is a 26 per cent rise compared to a week prior.
In comparison the growth of rate of incidental patients is nearly double that with a 51 per cent increase from 1,813 to 2,743 between December 21-28.
Regardless of if patient is being treated primarily for Covid or is an incidental case it still puts extra pressure on health service resources.
NHS England said Covid patients being treated for something else still have to be separated from non-Covid patients, adding that the virus can be ‘a significant co-morbidity’.
‘A subset of those who contract Covid in the community and are asymptomatic, or exhibited relatively mild symptoms that on their own are unlikely to warrant admission to hospital, will then be admitted to hospital to be treated for something else and be identified through routine testing.’
‘However these patients still require their treatment in areas that are segregated from patients without Covid, and the presence of Covid can be a significant co-morbidity in many cases.
‘Equally, while the admission may be due to another primary condition, in many instances this may have been as a result of contracting Covid in the community. For example, research has shown that people with Covid are more likely to have a stroke. In these cases people would be admitted for the stroke, classified as ‘with’ Covid despite having had a stroke as a result of having Covid.’
In London, the epicentre of the UK’s Omicron outbreak, there is a similar pattern to the rest of the nation, with one in three of the capitol’s 2,431 Covid patients on December 28 being incidental cases, a rise from a quarter of patients a week ago.
Primary Covid admissions in the capitol were also up compared to last week, with an additional 433.
The new detailed data on Covid admissions up to December 28 comes on the back of separate figures showing the number of patients in hospital with coronavirus in England had climbed to its highest level since February.
NHS England figures show there were 11,452 people in hospital in England with Covid as of 8am on Thursday, up 61 per cent from a week earlier and the highest number since February 26.
During the second wave of coronavirus the number of Covid patients in hospital in England peaked at 34,336 on January 18.
The data also shows there were 2,082 Covid hospital admissions in England on Tuesday, up 90 per cent week on week and the highest number since February 3.
It is also more than half the peak of 4,134 coronavirus hospital admissions reported on January 12 during the second wave of coronavirus.
But experts have called for caution over interpretations of the hospital numbers amid the rapid spread of Omicron, given that patients are suffering milder disease now than in previous waves.
Official data also shows the number of critically ill Covid patients remains stable, highlighting how the outbreak is now in a vastly different position to ever before.
But statistics looking at the situation in intensive care wards paints a much different picture, with just 232 patients hooked up to ventilators as of today. Rates are ticking up much slower, and are still a fifth of levels seen in January during the depths of the Alpha wave.
Ministers have said they are keeping a close eye on Covid data in determining whether to introduce new restrictions in 2022.
Chris Hopson, the head of NHS Providers, said new curbs ‘may be needed at pace if the evidence warrants it’ as he said health bosses ‘still don’t know’ if there will be a surge in elderly hospitalisations which could trigger Mr Johnson to act.
He told BBC Radio 4’s Today programme: ‘Look, it is the Government that sets the rules on restrictions, not the NHS and we know that the Government has set a high threshold on introducing extra new restrictions.
‘So on that basis trust leaders can see why the Government is arguing that in the absence of a surge of seriously ill older patients coming into hospital, that threshold hasn’t yet been crossed.
‘But we still don’t know if the surge will come and indeed we are exactly talking about the preparations that we are making for that surge right now.’
Mr Hopson said restrictions will need to be brought in ‘at pace if we need them’.
‘In terms of restrictions I think we are in exactly the same place we have been in for the last fortnight which is the Government needs to be ready to introduce tighter restrictions at real speed should they be needed,’ he said.
‘And just to make the point that is somewhat different to a headline that states that NHS leaders thinks there is no need for more curbs. They may be needed at pace if the evidence warrants it.’
‘And just one more important point I think, which is it is worth remembering that it does take about a fortnight for any new restrictions to effect the levels of hospital admissions so the pattern of hospital admissions for the next fortnight has already been set.
‘So in terms of restrictions we should bring them in at pace if we need them but trust leaders understand why the Government having set a very high threshold that actually that threshold hasn’t yet been crossed.’
In may not be just admissions that determine NHs pressures however with concerns on the number of health and care staff being forced off work due to catching Covid.
Nearly 25,000 staff were ill with the virus or self-isolating on Boxing Day, more than double the 12,000 stuck at home a fortnight earlier, NHS England statistics show.
And almost 28,000 Covid absences were recorded on December 23, the highest figure seen since NHS began publishing the data last month.
NHS England data shows a total of 68,082 staff were off sick on Boxing Day, the latest date figures are available for. More than a third of the absences (24,632) were because of Covid, up 31 per cent on the 18,829 who missed work because of the virus one week earlier. Covid absences have more than doubled in a fortnight, with just 12,240 off because they were infected or isolating two weeks earlier on December 12
Sheffield Teaching Hospitals NHS Foundation Trust recorded the highest number and proportion of Covid absences, with one in 16 staff members (1,144, 6.4 per cent) missing work due to the virus on December 26. Manchester University trust (835), Nottingham University Hospital trust (791), and Guy’s and St Thomas’ trust (568) recorded the next-highest number of Covid absences
Sheffield Teaching Hospitals NHS Foundation Trust recorded the highest number and proportion of Covid absences out of all trusts in England, with one in 16 staff members (6.4 per cent) missing work due to the virus on December 26. Homerton University Hospital trust (5.7 per cent), Royal Papworth Hospital trust (5.1 per cent) and North Middlesex University Hospital trust (4.8 per cent) saw the highest proportion of their workforce stuck at home with the virus – equating to around one in 20
British Medical Association chair Dr Chaand Nagpaul also warned ongoing struggles to secure Covid tests was exacerbating the situation, with thousands of medics unable to turn up for shifts because they cannot get tested ‘at a time of acute workforce shortages and winter pressures’.
The number of incidental Covid admissions in hospital and how they factor into Government decision making regarding pandemic restrictions has been a contentious topic in recent days.
Earlier this week former Tory leader Sir Iain Duncan Smith criticised the handling of the dat: ‘This is a nonsense. It’s almost certain that admissions for Covid are far lower than the figures suggest.
‘We cannot make decisions based on hospital admissions when we don’t know how many were admitted for other reasons and subsequently tested positive.’ He went on: ‘It also speaks very badly to the NHS’s ability to control Covid in hospitals when so many people are catching it there.’
He called for the independent Office for National Statistics to publish the figures for true Covid admissions, rather than the NHS.
Tory backbencher Sir Geoffrey Clifton-Brown said: ‘We need to be much clearer about what the primary purpose was of someone being admitted to hospital.
‘If they’ve got Covid later it’s wrong to ascribe that to a Covid admission. We should be much more straightforward with the statistics.’ Because hospital inpatients are now routinely tested for Covid, admissions data in England have always included those who were brought in for entirely separate reasons but were later found to be infected, either because they had it already or caught it in hospital.
From July, trusts were told to provide a breakdown of those who were primarily admitted because of acute Covid symptoms and those who were in hospital for other reasons.
Initially the figures showed that 20 per cent – one in five – of those in hospital with Covid were admitted for another condition. But the proportion has steadily grown before reaching a series of new highs in recent weeks.